PROJECT SUMMARY The goal of the Moffitt Cancer Center (MCC) Cancer Epidemiology (CE) Program is to contribute to a reduction in the cancer burden through research to identify risk factors across the cancer continuum comprising etiology, progression, and outcome, and the translation of that knowledge into successful prevention and early detection interventions. Rapid increases in information enabled by advances in technology have provided the opportunity to clarify underlying causes of cancer pathogenesis. The complexity of the collection of diseases known as cancer requires a robust approach and consideration for a broad array of biomarkers. The identification of markers that alter susceptibility to cancer allows for the development and testing of clinical cancer prevention strategies. To achieve its goal, the CE Program is organized into three specific aims focused on 1) identification and testing of acquired biomarkers of cancer risk and outcome, 2) examination of inherited susceptibility markers and associations with cancer risk and outcome, and 3) discovery and testing of promising approaches for the prevention and early detection of cancer. CE members investigate how biomarkers, some of which are modifiable, impact disease onset, progression, and outcome and whether these biomarkers can be brought forward into the clinical and public health realms for translational impact. Work is conducted in close collaboration with colleagues in the Health Outcomes and Behavior (HOB) Program, who seek to better understand behaviors that affect mutable biomarkers and modify those behaviors to decrease cancer risk and promote early detection. Thus, the specific aims of CE are highly complementary to those of HOB, and there is considerable synergy between members of both programs. The program comprises 24 members from six academic departments. Peer-reviewed funding is $6.7M in annual total costs, and the portion of this funding derived from NCI is $5.8M, representing 86% of the program's peer-reviewed funding. Program members have published 635 cancer-relevant scholarly articles including 58 in high impact journals (impact factor >10). In total, 174 (27%) of all publications represent intra- programmatic collaborations, 147 (23%) represent inter-programmatic collaborations, and 292 (46%) reflect inter-institutional collaborations with other NCI-designated Cancer Centers. Indeed, CE members currently have 37 inter-institutional collaborative awards. Scientific investigations led by program members have helped advance knowledge of risk factors, including methylation markers, human papilloma and other viruses, microRNA signatures, and genetic polymorphisms, for numerous cancers that are the major contributors to mortality and morbidity in the MCC catchment area, and for other cancers. CE Program members also are active in translating their work through developing better vaccines, botanical chemopreventive agents, and automated digital imaging to impact clinical and public health practice.